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Monday, 21 January 2019 (PANCAP Coordinating Unit, CARICOM Secretariat): The PANCAP Priority Areas Coordinating Committee (PACC), the technical group of the PANCAP Executive Board commissioned an evaluation of the Caribbean Regional Strategic Framework on HIV and AIDS (CRSF) 2014 – 2018. The PACC is responsible for the coordination and overseeing the implementation of operational plans for the CRSF.

The overall goal of the CRSF 2014-2018 was to halt the spread and reduce the impact of HIV in the Caribbean while promoting a sustainable response within Member States. The indicators developed to determine the overall achievement of the stated goal included the percentage of persons aged 15 – 49 years diagnosed with HIV in the last 12 months; percentage of children born to HIV-infected mothers who are infected; percentage of persons living with HIV (PLHIV) on treatment (ART) and virally suppressed; and Domestic and International AIDS spending by category and funding sources.

METHODS

The evaluation was conducted between April and November 2018 with three objectives: 1. Obtain feedback from the regional partners as to the progress, achievements, and gaps of the regional HIV response; 2. determine the level of implementation of the CRSF, the progress, achievements, gaps and challenges; and 3. provide clear recommendations on the strategic priority areas for the new CRSF and to inform its development.

The evaluation was conducted in two phases; Phase 1: Collection and analysis of survey data from a Partner Self-assessment and a Partnership Assessment; and Phase 2: Collection and analysis of data for key indicators of the CRSF 2014-2018 to help the Partnership determine the progress made, particularly in relation to impact and outcomes. During Phase 2, a virtual consultation was conducted among government and civil society partners from countries with the highest number of respondents to the partnership assessment to corroborate the perceptions obtained from the surveys and to determine whether the trends that emerged from the surveys remained or varied significantly. The draft evaluation report was reviewed by PACC members and amended to improve its analytic depth and clarity.

FINDINGS

The findings for each of the Six Strategic Priority Areas are presented in the full evaluation report.

The evaluation found that while the Caribbean has made progress in responding to the HIV epidemic, the impact of the prevention response has been inadequate, particularly among key populations. Of concern is that the annual number of new HIV infections among adults in the Caribbean declined by only 18% from 2010 to 2017, from 19,000 [14,000–31,000] to 15,000 [11,000–26,000]. Key populations, Men who have sex with men (MSM), Sex Workers (SWs) and their clients, and partners of key populations, transgender persons, and persons who use drugs, accounted for the majority of the new HIV infections (68%) during this period.

Conversely, new infections among children fell from an estimated 2,300 in 2010, to 1100. However, although significant progress has been made in eliminating mother-to-child transmission of HIV, available data for the period 2015 – 2017 showed that HIV infected pregnant women receiving ART to reduce HIV transmission declined from 92% in 2014 to 79% in 2015 and 75% in 2016 and 2017 respectively, illustrating a significant decrease that requires investigation.

There has been progress in placing more people living with HIV on treatment, however much more needs to be done to increase the numbers and to retain people on treatment. In fact, significant effort is required for the Caribbean to achieve the UNAIDS 90-90-90 Targets (90% of people living with HIV are aware of their infection, 90% of people diagnosed with HIV are linked to antiretroviral treatment (ART) and 90% of those on ART adhere and have undetectable levels of HIV in their blood). The gap to achieving the first 90 of the 90–90–90 Targets in 2017 was 54,800 people living with HIV [1].

The gap to achieving the first and second 90s of the 90–90–90 Targets in 2017 was 74,700 people living with HIV. The percentage of people living with HIV who achieved viral suppression increased from 37% in 2016 to 40% in 2017.

However, the gap to achieving all three 90s at the end of 2017 was the need for an additional 103,000 people living with HIV to be on ART and be virally suppressed. Given this situation, the Caribbean is at risk of not achieving the 2020 Targets.

Global financial resources to support the HIV epidemic have been progressively decreasing since 2011. However, domestic financing has improved during the implementation of the CRSF 2014-2018[2]. UNAIDS 2018, noted that “domestic resources increased between 2006 – 2017 by 124%, while international resources declined by 16%”[3]. As at the end of 2017, domestic resources were contributing significantly to the cost of ART and the overall treatment programme. Despite this trend, national resources to support services to achieve prevention continue to be low[4], with the implication that the gains could be reversed if this gap is not quickly filled.

The evaluation team proposed a number of overall recommendations for the goal as well as specific recommendations to address the gaps and challenges identified under each Strategic Priority Area. Additionally, the team proposed that the following Strategic Priority Areas should be retained in the new CRSF: An Enabling Environment, Prevention of HIV Transmission, Treatment, Care and Support, Integrate HIV into Health and Socioeconomic Development and Sustainability.

The evaluation team further proposed that a new Strategic Priority Area – Strategic Information, Monitoring and Evaluation, and Research, should replace Strategic Priority Area – Shared Responsibility to bring into sharper focus the importance of countries’ capacity to report on HIV data nationally, regionally and internationally, including on the CRSF indicators. Such emphasis would enable better reporting on, and profiling of the epidemic in the Caribbean. The main activities that fell under “Shared Responsibility” will be subsumed into the existing Strategic Priority Areas so as to ensure continuity of these initiatives in the new CRSF.

The Priority Areas Coordinating Committee, which was convened virtually on 10 January 2019 accepted the evaluation report. The PANCAP Executive Board which was convened virtually on 17 January 2019 also accepted the evaluation report and thanked those responsible for preparing the report; recognized that while the Caribbean has made progress much more needs to be done to achieve the targets; called on all countries and the Partnership to renew efforts to build capacity and work together to achieve the targets.

The Execute Board noted the legal judgments in Caribbean courts affirming human rights arising from litigation and called on countries not to wait on litigation but to make amendments to laws to recognize the rights of key populations and the rights of all to access sexual and reproductive health services. The board also noted that while tens of thousands of cases of HIV infections have been prevented there is a need to significantly reduce new infections, and this requires that countries promote age-appropriate sexual education and skills and extend sexual reproductive health services to all youth and key populations.

The board also called on all countries to introduce innovative prevention approaches and improve the quality of prevention services to ensure greater impact in reducing new HIV infections, and furthercalled on the Priority Areas Coordinating Committee to develop a new Caribbean Regional Strategic Framework on HIV and AIDS for the period 2019 to 2023.

PANCAP is a Caribbean regional partnership of governments, regional civil society organizations, regional institutions and organizations, bilateral and multilateral agencies and contributing donor partners which was established on 14 February 2001. PANCAP provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, coordinates the response through the Caribbean Regional Strategic Framework on HIV and AIDS to maximize efficient use of resources and increase impact, mobilizes resources and build capacity of partners.

What are the Joint United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 Targets?

By 2020, 90% of all people living with HIV will know their HIV status.

By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.

By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

The year 2018 is rapidly drawing to a close. I would like to share my reflections on some key achievements during this year. There has been further assessment of our progress and gaps in the response through the evaluation of the Caribbean Regional Strategic Framework on HIV and AIDS 2014-2018 and the mid-term evaluation of the CARICOM-PANCAP and UNDP-CVC-COIN Global Fund projects. These assessments will be used to inform the development of the new CRSF and adjustment to Global Fund grant activities to achieve the desired outcomes.

PANCAP continued to make its presence felt, expand knowledge sharing and communicate its added value to the region through its Knowledge for Health Project.

A key output of the PANCAP component of the CARIFORUM 10th European Development Fund was a position paper on the human rights situation in the region, which brought together the achievements, gaps, and challenges in one document while highlighting the critical need for justice system reform as a means of increasing key populations’ access to justice.

A Framework for Migrant Health and Rights was developed to serve as a pragmatic approach to migrant populations, which recognizes that a non-discriminatory strategy for public health benefits the entire population. The Framework is rationalized with the vision of regionalism under the CSME and sets out guiding principles and recommended strategies for regional and national action. It was endorsed by the 35th COHSOD – Ministers of Health and operationalization will begin in 2019.

Our youth have been engaging in high-level advocacy with ministers of health and education around issues of sexual and reproductive health and rights. There has been joint dialogue between faith leaders and other groups including key populations, youth, NAP managers and civil society leaders. These engagements are aimed at increasing youth’s access to SRH services, integration of comprehensive sexuality education and development and implementation of gender-inclusive policies and integration of comprehensive sexuality education into the Health and Family Life Education curriculum, as well as the adoption of CARICOM Anti-Discrimination Legislation by countries.

We continue to engage in dialogue regarding the judgmental attitudes towards LGBTI persons and justice for key populations following the Trinidad and Tobago High Court Ruling that the Buggery Law is unconstitutional and the Caribbean Court of Justice (CCJ) Ruling that Guyana’s Crossdressing law is unconstitutional.

We have seen greater ownership of the Partnership by its members through shared responsibility. While external funding is steadily declining, donors are supporting the region to transition responsibly.

The Partnership was supported by USAID-Abt Associates Health Finance and Governance Project to revise the PANCAP Resource Mobilisation Strategy and Plan 2018-2020 to garner resources to support the achievement of regional goals and targets articulated in the Caribbean Regional Strategic Framework on HIV and AIDS.

PANCAP-CVC-COIN joined forces to submit a proposal to the Global Fund in the amount of US$6.5 million over three years. The consortium has been requested to proceed to grantmaking following the Technical Review Panel’s approval. PEPFAR-USAID approved another year of funding for the fiscal year 2019 to support PANCAP’s coordination function and the PEPFAR-USAID funded Knowledge for Health Project also received an extension to 2019. UNAIDS committed financial resources to support the documentation function of PANCAP.

The Caribbean Med Labs Foundation (CMLF) celebrated its 10th Anniversary in August and has recommitted to providing the leadership required for laboratory strengthening in the region.

CRN+ convened its Biannual General Meeting and elected a new Board of Directors to provide the oversight for its work. The Regional Monitoring and Evaluation (M&E) Technical Working Group broadened its mandate beyond HIV to include the M&E for the Caribbean Cooperation in Health IV. Under the CARICOM-PANCAP Global Fund Grant, PANCAP continued sensitization of the CARICOM Secretariat on the linkages between HIV, human rights and social development programmes and identified opportunities for collaboration during the annual work programme planning at the Secretariat. This is beginning to bear fruit as evidenced by the joint activity between the PANCAP Coordinating Unit and the Gender Unit to commemorate the Launch of the World AIDS Day 2018 theme and 16 Days of Activism to end Gender-based Violence.

In 2019 the Partnership will develop a new Caribbean Regional Strategic Framework for HIV and AIDS that is informed by the CRSF 2014-2018 evaluation, implement the PANCAP Resource Mobilisation Plan, and leverage the comparative advantage of development partners for transition and sustainability of both national and regional responses.

I take this opportunity to thank the staff of the PANCAP Coordinating Unit for their stellar performance and unwavering support for the work of the Partnership.

Do you know your status? If you do not, as Champions for Change we urge you to do so this World AIDS Day so you can feel empowered.

Know Your Status is the theme for World AIDS Day this year. It is both a call to action and an opportunity to celebrate the achievements that have been made and recommit ourselves to continue the work towards the end of AIDS as a public health threat by 2030. The success of the regional response is evident in significant achievements for the Caribbean especially since seven of our Caribbean countries were recognized on World AIDS Day last year for eliminating the transmission of the HIV virus from Mother to an unborn child. In April 2015, Cuba became the first country in the world to achieve the target for elimination of mother-to-child transmission of HIV and Congenital Syphilis, along with 6 additional countries (Anguilla, Antigua and Barbuda, Bermuda, Cayman Islands, Montserrat, and Saint Kitts and Nevis, in 2017).

UNAIDS World AIDS Day 2018 data collected in 2017, reveals that we still have much to do and each of us needs to take action.

Our Caribbean region still has 310, 000 people living with HIV

The number of new infections among adults stands at 15, 000 [11 000–26 000] as reported in 2017.

Adults aged 15 years and over, there are reports of 14,000 new infections [10 000 – 24 000]

New infections among children (aged 0–14 years) are an estimated 1100 [710–1900] in

AIDS-related deaths in 2017 were an estimated 10 000 [7100–17 000]

181,000 Caribbean people living with HIV were on treatment in 2017

Treatment coverage for pregnant women accessing treatment is at 75% but only 58% for adults 15 years and older and just 52% for children 0-14 years and 57% overall for all people living with HIV.

This tells us that despite these efforts and in spite of the overall gains towards epidemic control, throughout the Region, prevalence continues to be higher in key populations, including women, MSM, transgender, sex workers, youth, migrants and mobile populations, incarcerated persons and people who use drugs. The legal, social and cultural barriers that drive transmission and prevent key populations from accessing comprehensive and high-quality health services are deeply rooted in Caribbean cultures and societies. As the Region is faced with rapidly declining donor support to HIV programming, interventions targeted at key populations, including through community-based organizations (CSO), are likely to be most affected, especially as national programs are challenged to find the resources needed to scale-up treatment programs in line with Treat All. At a minimum, there must be a commitment at the regional and national level to sustaining investment in prevention, treatment, communication for development, moral and values education and care programs.

It is now, therefore, a strategic imperative to work in partnership and collaboration with all stakeholders, operating as a unified, coherent and cohesive whole (without prejudice to individual/respective organizations objectives) in order to achieve the overall goal of ending AIDS as a public health threat by 2030.

Each of us must do more, and we can start by simply doing an HIV test- today or as soon as possible- which will allow us to seek treatment or continue and improve our prevention efforts. Our region needs our collective action!

This year’s World AIDS Day theme “Know your status” encourages us to be tested to know whether we are HIV negative or positive. This theme is very relevant as the world has committed to Fast Track actions towards achieving the 90-90-90 treatment targets by the year 2020. The UNAIDS 2018 Global AIDS Monitoring (GAM) report informs us that there are an estimated 310,000 adults and children living with HIV in the Caribbean, of which nearly 55,000 are unaware that they have HIV.

While many people experience anxieties when contemplating being tested, it is good to know that the majority of these will test HIV negative. What is important is those who know that they are HIV negative have an incentive to keep themselves free from HIV by adopting changes to their lives that can reduce their risk and vulnerability to HIV. The few who test positive for HIV can have immediate access to life-saving antiretroviral drugs that would enable them to enjoy a good quality life and live much longer.

The 2018 UNAIDS GAM report also helps us to understand that we still need to place 74,400 persons who are living with HIV on treatment and 103,000 are yet to achieve viral suppression, that is, having very low levels of virus in the body, even though the virus is still present.

Science and evidence show that AIDS can be defeated once we get 90 percent of people to know their HIV status, of those who are HIV positive 90 percent receive anti-retroviral drugs and are retained in care, and 90 percent of those on treatment achieve viral suppression. Once this happens, we are well on the way to achieving the end of AIDS, by 2030.

So what is stopping us from achieving these 90-90-90 targets? The biggest challenges we face are persistent judgment and unfair treatment of people living with HIV and persons belonging to key population groups such as gay men and other men who have sex with men, transgender persons, sex workers, persons who use drugs, migrants and other mobile populations, and persons with disabilities. We judge persons who are different from us and we often times treat them differently. We do so because we do not take the time to understand. This year’s theme must, therefore, serve as a catalyst for increased strategic advocacy using the PANCAP Regional Advocacy Strategy 2017 and national advocacy plans for increasing political will to remove the policies and legislative barriers that obstruct people from coming forward to know their HIV status. The fear is real as people are concerned that they will be treated differently if they test positive.

We must bring into the spotlight the critical need for laboratory improvements and increased coverage in our region. We need more laboratory facilities including those led by the communities themselves to know our status. We need laboratories to confirm community-led HIV screening tests. We need laboratories and point-of-care diagnostic systems to monitor our viral loads and health care providers who are trained to provide clinical management for HIV-related illnesses.

We cannot get people tested if we do not have test kits, the right diagnostic equipment, and the right human resources. When we talk about placing 90 percent of people who are HIV positive on treatment and retaining them on treatment we must also ensure that we do not have stock-outs of key drugs. How can we be taken seriously when we encourage people to be tested and then fail to provide uninterrupted treatment? How can we fail to respond to people living with HIV when sometimes drugs are not available and people become anxious because their health care provider had stressed the importance of adherence to treatment and the impact of non-adherence on their health, including the potential for drug resistance?

If we are serious about getting people to know their status, we must move beyond the rhetoric to decisive actions to demonstrate that we understand the full implication of what it means to move someone who tests HIV positive to sustained viral suppression. We must guarantee good quality laboratory testing and laboratory services, uninterrupted treatment and monitoring within our health care system. And we must begin to tackle the reform of the justice system to enable persons who suffer discrimination to obtain redress in a timely manner. This calls for the engagement and involvement of our ministries of justice and attorneys general among others.

I call upon our governments and all who can make this happen to take the necessary actions to create an enabling environment in which people who want to know their status can come forward with the knowledge that they will not be treated differently, and that if they test positive they will be provided with the treatment, care and support they need to enjoy good quality lives and achieve viral suppression. Only then can we get them to know their status and begin the journey towards ending AIDS as a public health threat in the Caribbean.

As we mark another World AIDS Day, 30 years after the start of this epidemic, we have come a long way and are fortunate to today be standing in a better place than in prior years. But after 30 years, AIDS is still not over as yet and we have much more work to do.

Today the Caribbean Regional Network of People Living with HIV (CRN+) commemorates World AIDS Day under the theme “Know Your Status”. This theme is meant to encourage every individual who do not know their HIV status to GET TESTED NOW. Many barriers to HIV testing remain and UNAIDS estimates that more than 9.4 million people living with HIV still do not know their status. Stigma and discrimination deter people from taking an HIV test. If people don’t know their HIV status, people who are living with HIV can’t start treatment, and people who are HIV-negative can’t get the knowledge and skills they need to keep that way.

HIV has always had an enormous impact on individuals and communities. Children, mothers, and fathers are affected by each new infection. HIV knows no economic or geographic boundaries. This diverse Caribbean of ours has the second highest HIV prevalence (1.3%) in the world outside that of sub-Saharan Africa, with 310,000 persons estimated to be living with HIV.

A renewed call to the people of the Caribbean: Get tested!

We must continue to shout out and pledge that stigma and discrimination end with me. Let us commit to reinvigorating our efforts to realize a world free of AIDS and to ending the scourge of discrimination.I urge our fellow Caribbean countries to protect the basic human rights of ALL people, especially people living with HIV, including their rights to physical and mental health and well-being, social and economic opportunities, and full participation in shaping prosperous and sustainable societies.

Even as CRN+ joins the rest of the world in remembering those we have lost by marking World AIDS Day 2018, we must also take hope in the successes we have made to date. We call upon all Caribbean people who have not yet taken an HIV test to do so today. 54,800 people living with HIV in the Caribbean do not know their status. Knowing your HIV status is very important and the experience can help to either strengthen your efforts to stay HIV-free or guide you to the treatment and care services that will allow you to live a long, healthy and productive life with HIV.

This is our 30th commemoration of World AIDS Day. Over the last three decades the global response to HIV has evolved from a place of desperation to one of hope. Today we have a formidable toolkit to prevent HIV infections and deaths.

Babies of mothers living with HIV can be born HIV free. HIV positive people can be treated so that the level of virus in their blood is undetectable and they are no longer infectious. HIV negative people can take medicines to prevent contracting the virus. All this was unimaginable during the 1980s. In short, we now have the tools to end the AIDS epidemic. Yet the pace of progress is not matching global ambition.

This year’s World AIDS Day theme points to a simple action that ordinary people can take to bring us closer to that goal: know your status.

HIV testing is a critical strategy for both prevention and treatment. For people who test negative there is the occasion to assess their risks and devise a strategy to stay HIV free. For those who test positive there is an opportunity to start treatment, stay healthy and thrive.

An estimated 77% of people living with HIV in Latin America and 73% of people living with HIV in the Caribbean knew their status in 2017. This means that roughly one of every four HIV positive people in our region are not aware. Knowledge is power. Knowing your status means you can take steps to protect yourself and others. People’s ignorance of their HIV status undoubtedly contributed to the 100,000 new infections in Latin America and 15,000 new infections in the Caribbean last year.

In 2017 29% of newly diagnosed cases in Latin America and almost quarter of new diagnoses in the Caribbean were among people at an advanced stage of infection. This is a particular risk factor for men who are less likely to go to the clinic or visit a doctor unless they are gravely ill. It is in everybody’s interest to build a culture in which regular HIV testing is expected and supported. This makes early diagnosis, effective treatment and prevention possible.

Just as there have been innovations in treatment, there have also been innovations in testing. Throughout our region there is free access to rapid HIV testing. It takes just minutes to learn your status.

HIV self-tests are becoming more widely available. Brazil has led the way in terms of regulating this industry and ensuring that people have the information and resources they need to follow-up following a home test.

Community organizations are using peer outreach to test the most marginalized and vulnerable populations. We encourage governments to do more to support these organizations in reaching the people who find it difficult to access public healthcare services.

Service providers are increasingly using a method called index testing which involves offering tests to the sexual partners, children and other household members of people who have been diagnosed.

Governments, healthcare systems, civil society and development partners are all playing their parts. You can play your part by getting tested.

This year marks the 30th anniversary of the first World AIDS Day. Thirty years of activism and solidarity under the banner of World AIDS Day. Thirty years of campaigning for universal access to life-saving services to treat and prevent HIV. But after 30 years, AIDS is still not over. We have miles to go.

World AIDS Day is a day to remember the millions of people who have lost their lives to AIDS-related illnesses, many of whom died because they couldn’t access HIV services, because of stigma, because of discrimination and because of criminalization of key populations.

On this World AIDS Day, UNAIDS is campaigning for people to know their HIV status and their viral load. In 2017, 9.4 million people were simply unaware that they are living with a potentially deadly, but treatable, disease. If people don’t know their HIV status, people who are living with HIV can’t start treatment, and people who are HIV-negative can’t get the knowledge and skills they need to keep that way. If people don’t know their HIV status, they can’t protect themselves, their families, their partners. If people living with HIV don’t know their viral load, they won’t be sure that the treatment is effective, protecting their health and stopping HIV transmission.

Thirty years after the first World AIDS Day, the response to HIV stands at a crossroads. Which way we turn may define the course of the epidemic — whether we will end AIDS by 2030 or whether future generations will carry on bearing the burden of this devastating disease.

More than 77 million people have become infected with HIV and more than 35 million have died of an AIDS-related illness. Huge progress has been made in diagnosis and treatment, and prevention efforts have avoided millions of new infections.

Yet the pace of progress is not matching global ambition. New HIV infections are not falling rapidly enough. Some regions are lagging behind and financial resources are insufficient. Stigma and discrimination are still holding people back, especially key populations — including gay men and other men who have sex with men, sex workers, transgenders, people who inject drugs, prisoners and migrants and young women and adolescent girls. Moreover, one in four people living with HIV do not know that they have the virus, impeding them from making informed decisions on prevention, treatment and other care and support services.

There is still time to scale up testing for HIV; to enable more people to access treatment; to increase resources needed to prevent new infections; and to end the stigma. At this critical juncture, we need to take the right turn now.

Written by Subraj Singh, Society against Sexual Orientation Discrimination (SASOD)

Earlier this year, I spoke to Marvin Livan and Peter Pooran, a young same-sex couple, who identify as LGBTQ+ Guyanese, as well as church-going Christians. Their story is unusual and beautiful and serves as a reminder that there are still people in the world who use their faith to do good, people who try to represent the tenets of the Bible, which teaches love and acceptance for all people.

Marvin and Peter use their religion in a way that brings them closer together as a couple. Perhaps this is unsurprising given that the duo actually met in a church. Prior to recounting the events of the day when they first saw each other, Marvin acknowledged that although he had been married to a woman before, he had come to a point in his life where he had to authentically face his attraction to men, and therefore, when he saw Peter in church on that particular day, it was easy for Marvin to approach and talk to him.

The church tradition helped to facilitate the meeting of the two young men, since it is customary in for the congregation to mingle at the end of the service, to converse or maybe just hang out. It was in one of these moments after the church-service that Marvin took Peter’s copy of the Bible and wrote his number at the back, with the advice to call him if Peter ever wanted to talk. Although there was an attraction from their first meeting, Peter did not call Marvin right away. After several months, Peter’s call led to the men conversing more often and this laid the foundation for their romantic relationship.

Marvin notes that even though their relationship has the normal ups and downs that are experienced by every young couple, he believes that their relationship is strong, especially with the emphasis that they put on being together and on being faithful to each other. He also says that he has been accepted as a member of the Anglican Church and that although there are people within the church who know about his relationship with Peter, he is still accepted and he still maintains his status as an avid churchgoer. Marvin hopes to one day become a priest and to be able to invite LGBTQ+ persons into the “house of God.” As a priest, he hopes one day to facilitate persons to serve in the church if they have the call to serve, regardless of their sexual orientation and gender identity. Marvin credits his love of church and the joy he feels being a Christian to his religious upbringing and to those who encouraged him to become an altar boy when he was a child.

Peter for his part shares that he is as religious as his partner, pointing out that he has been going to church since he was seven years old. When he met Marvin, he was hesitant about attending his partner’s church. However, after seeing the impact the Anglican Church had on Marvin, Peter finally decided to give it a chance. He describes his experience of stepping into the church in terms of profound sanctity and credits this joy and sense of fulfillment he experienced in the church as the reason for his continued presence there.

Peter believes everyone, regardless of their sexual orientation and gender identity, should come forward to serve the Lord. This is something that Marvin also advocates for, as he maintains that the church can be a place of education on gender and sexual diversity and a place for LGBTQ+ persons to meet other people who intersect with the Christian community, such as Marvin and himself. Marvin firmly believes that Jesus loves LGBTQ+ people exactly as they are.

Peter plans on coming out to the priest of the church they attend, and this truly seems to be important to him, which is unsurprising since many gay people long to be accepted in any social group or institution as their true, authentic selves. He is convinced that the reactions of fellow parishioners to him will not change and that he will continue to be accepted in the church, as there are already some people in the church who are aware of their relationship.

On the reactions of other sections of the Christian community who preach homophobia, Marvin contends that the evidence for a case against homosexuality in the Bible is weak and sees his sexuality as a blessing from God. He also emphasizes the fact that everyone sins and that there are aspects of the Bible that are conveniently left unaddressed by homophobes in order to maintain a lack of culpability and repentance for the sins they also commit that are outlined in the Bible.

Both men believe that human beings are human beings and they should be allowed into the church because sexual and gender minorities have the same emotions and beliefs as everyone else, and people should have the right to believe in and serve God.

Being so vocal about the church and sexuality issues places Marvin and Peter in a special category of Christians who are able to reconcile their love for each other and their religion in a way that does not require them to compromise their feelings about who they are and about the church in any way. They firmly believe that the church can support LGBTQ+ people to live their truth and that it is the Christian way to welcome all, to represent goodness and kindness, regardless of who the person is. They both are extraordinary not only in their love for each other but in their dedication to their faith and the ways in which they want these two major parts of themselves to come together and work for the betterment of the entire world.

The Department of Pathology, The University of the West Indies (UWI), was presented with the Certification (Award) of Accreditation in conformance with the ISO 15189:2012 International standard from the Jamaica National Agency for Accreditation (JANAAC). The honour was bestowed on the occasion of the 10th Anniversary of the Jamaica National Agency for Accreditation (JANAAC), at an awards function hosted at the Jamaica Pegasus Hotel in Kingston, Jamaica.

The accreditation scope for the Department of Pathology includes Chemical Pathology, Haematology, Flow Cytometry, and Cytology.

In her remarks, Mrs. Smith-Valentine expressed gratitude to the Head of the Department of Pathology , Dr. Gilian Wharfe, the Director of the Accreditation committee, Dr. McGrowder, the Quality Assurance Team (Mr. R. White, Mrs. G. Martindale-Williams, Mrs. G. Hamm, Mrs. C. Green, Mrs. A. Low-Lewis, Mr. G. Burnell and Mr. K. Vaz), and all staff members in the Sub-Departments for working assiduously in making the milestone possible.

“We have been working towards this milestone since 2002, and it would be negligent of me not to recognize the hard-working staff now retired (Mrs. V. Hanson, Mrs. V. Smith, and Mrs. J. Powell-Jones) who worked alongside Dr. McGrowder to drive this process before I came onboard in 2014”, said Mrs. Smith-Valentine.

She concluded that as the Department of Pathology moves forward, the goal is to continue to strive for excellence in the services offered to clients through the competence of staff and the quality work generated.

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